脑卒中偏瘫患者步行速度与步长和步频的关系

Relationship between walking speed and step length and walking rate in hemiparetic stroke patients

目的探讨脑卒中偏瘫患者步行速度与步长和步频之间的相互关系。方法30例恢复步行能力的脑卒中偏瘫患者,测定在自由状态的10m步行速度,求得患者的步行速度、步长和步频等时间-距离因子。对步行速度、步长和步频间进行Pearson和Spearman相关分析及回归分析和逐步回归分析。结果30位患者的步行速度为35.45(4.10～67.40)m/min,平均步长为34.41cm,平均步频为91.59steps/min,步长步频比为0.0038(0.0020～0.0054)犤m/(steps·min)犦。患者的步行速度与步长和步频之间呈高度正相关(r=0.957和r=0.874,P<0.001);步长和步频之间也呈正相关(r=0.781,P<0.001);步长步频比与步行速度之间的相关性差(r=0.280,P>0.05)。回归分析发现步行速度与步长和步频之间存在线性回归关系(R2=0.915和R2=0.763,P<0.001),步长与步频之间也存在线性回归关系(R2=0.610,P<0.001)。逐步回归分析发现步长对步行速度的影响最为显著(R2=0.878,P<0.001)。结论脑卒中偏瘫患者自由步行速度与时间-距离因子步长和步频之间存在规律性的关系,研究结果有助于优化患者的步行训练。

Aim To investigate the relationship bet ween the walking speed and the two temporal-distance parameters:step length and walking rate in hemiparetic stroke patients.Methods Thirty hemiparetic stroke patients with the underlying diseases of cerebral infarction(n=21)and cerebral hemorrhage(n=9)who had recovered their ability to wa lk in-dependently were asked to walk comfo rtably without a brace or orthopedic instrument for ten meters three time s so as to detect the temporal-distan ce parameters:walking speed(WS ),step length(SL),walking rate(WR)and step length-walking rate ratio(SL /WR).Pearson' s correlation anal-ysis,Speramen' s correlation analysis,regression analysis,and multiple linear regression analysis using th e stepwise method were conducted to examine the relationships between WS and SL and between WS and WR.Results The WS of the 30patients was 35.45(4.10-67.40)m /min,the mean SL was 34.41cm,the mean WR was 91.59steps /min,and the SL /WR was 0.0038(0.0020-0.0054)(m /steps /min).Pearson' s correlation analysis showed that th e patients' WS was highly positively correlated with their SL and WR(r=0.957and r=0.874respectively,both P<0.001),that WS was not correlated to SL /WR(r=0.280,P>0.05)and that SL was significantly positi vely correlated to WR(r=0.781,P<0.001).Regression analysis showed linear relationships be-tween SL and WS (R 2 =0.915,P<0.001),between WR and WS (R 2 =0.763,P<0.001),and between SL and WS (R 2 =0.610,P<0.001).Step regression analysis selected step length as a significant variable for walking speed(R 2 =0.878,P<0.001).Conclusion A linear regression relationship exists between the walking speed and ste p length and between walking speed and walking rate in hemiparetic stroke patients,just as the case in healthy persons.